NJ Officials Investigating Deadly Viral Outbreak at Rehab Hospital

Specialty facility in Passaic County has suspended admissions after seven children died, 11 more infected

Credit: NJTV News
Gov. Phil Murphy looked on as Health Commissioner Dr. Shereef Elnahal addressed a hastily arranged press conference on the adenovirus outbreak at Wanaque.
New Jersey health officials have launched an investigation — with assistance from federal partners — into the origin and spread of a viral outbreak that has killed seven young patients and infected 11 others at a specialty hospital in Passaic County. The state has also installed a daily monitor onsite and the facility has suspended admissions until the outbreak abates.

Gov. Phil Murphy and Health Commissioner Dr. Shereef Elnahal held a hastily arranged press conference Wednesday evening at the Wanaque Center for Nursing and Rehabilitation where the adenovirus outbreak has impacted 18 residents ranging from toddler to young adult, most of whom depended on ventilators to breathe. Some have been transferred to other nearby hospitals for more intensive inpatient care.

“We are all obviously completely and utterly gutted by the knowledge that seven young, precious children have lost their lives,” said Murphy, who had returned from an overseas trip yesterday, adding his voice to a growing chorus of public officials who are expressing their horror over the incident.

Adenovirus poses no immediate threat to the public at large, Murphy stressed, including to staff and family members visiting the facility. While the particular strain of the virus that infected patients at Wanaque generally causes mild, cold-like symptoms in most healthy people, it can spread easily in close quarters like hospitals or dorm facilities, and the hospital’s residents were medically fragile and highly susceptible to this variant of the disease, officials said.

“This is a very tragic situation,” Elnahal said. “These are patients who, at baseline, need a lot of care, focus and attention.”

Government record of inspections

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Wanaque Center for Nursing and Rehabilitation
Government inspections have identified a variety of deficiencies at the Wanaque center in recent years — ranging from lapses in patient care, to gaps in infection prevention protocols, to stained and smelly carpet. But Elnahal stressed that these were relatively minor. Wanaque officials have been cooperating with state officials, he said, and have complied with all recommendations that have been made so far.

There are few specifics on the deaths and the timeline related to patient infections and family notifications; Murphy and others said many questions do remain about what has happened so far. State officials said Wanaque administrators first reported to the DOH that patients showed symptoms of the virus in late September and confirmed they had at least one patient infected with the adenovirus on October 9. Administrators there told parents of infected patients about the outbreak more than a week later, on October 19. It is not clear when the first six young patients died, but the seventh passed away on Tuesday, state officials said.

Once the DOH was informed of the outbreak, as required by regulation, the department immediately provided guidance on infection control practices — including separating infected patients from those without the virus. It has sent two inspection teams to the facility in recent days, a spokesperson said, including a surprise visit over the past weekend.

“As a parent, it’s just mindboggling,” said Sen. Joseph Vitale (D-Middlesex), who heads the Senate health committee and spoke with state health officials Tuesday night. He urged the Department of Health to review operations at similar facilities statewide to ensure proper infection protocols and other care practices are in place.

Union officials who represent some of the healthcare workers at Wanaque also raised concerns Wedneday about staffing levels and the availability of medical supplies like gowns and gloves, which can help prevent infection spread. They questioned the level of transparency around the situation, suggesting the facility’s administrators were not proactive enough in communicating the severity of the outbreak to employees and family members.

Working to keep outbreak under control

Officials at Wanaque did not respond to requests for comment on Wednesday or answer questions about their response to the outbreak, the notification process, and any staffing issues.

But the state DOH said it is now working closely with Wanaque administrators and local public health officials to ensure the outbreak is controlled. The department is also searching for its origin and monitoring its evolution, with input and testing assistance from the federal Centers for Disease Control and Prevention.

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Colorized microscopy image of adenovirus
Elnahal said the state is getting daily updates from those caring for the 11 surviving infected patients and carefully monitoring others at Wanaque to ensure the virus doesn’t spread; if no new cases are detected for four weeks, an outbreak is considered to be over. He said adenoviruses are a class of infection that are not uncommon in shared living quarters like hospitals and can cause symptoms ranging from pink eye to bronchitis to more severe infections, which can be deadly in those with compromised immune systems.

“I am confident that the steps being taken by state and local officials will minimize the impact to all those who remain at the facility, including patients and employees,” Murphy said.

While he stressed that the adenovirus outbreak is not a threat to public health, Murphy urged people to remember the importance of basic infection prevention — particularly hand-washing — especially as flu season approaches; last year the flu virus was particularly deadly and widespread.

“These events should be a loud wake-up call,” the governor said.

Union raises issue of staffing shortages

The Wanaque center, which is licensed for 92 beds, is under the umbrella of Continuum Healthcare LLC, a for-profit company that operates skilled nursing and rehabilitation facilities in New Jersey and Pennsylvania; these include nursing homes in Bloomingdale, Galloway and Trenton. Wanaque includes a nursing home and a pediatric center devoted to caring for medically fragile youngsters, including patients whose care involves addressing intellectual or developmental disabilities.

While state officials did not fault the facility’s operations, leaders at 1199SEIU, a labor union that represents nearly 140 Wanaque workers, pushed the hospital’s administrators for clarity on the outbreak and their response. Both 1199SEIU and the Health Professionals Allied Employees, or HPAE, which represents some 70 nursing staff at the center, raised concerns about the impact staffing shortages could have had on the situation.

“We are deeply concerned by reports suggesting that Wanaque Center may have kept the severity of this outbreak from family members and staff,” said 1199SEIU vice president Ron McCalla — a worry echoed by the parent of a Wanaque patient who attended the governor’s press conference Wednesday and said she had been told little about the outbreak. “It is imperative that a full accounting take place of when and how this outbreak began and how it is now being addressed,” McCalla said.

Vitale, a longtime public health champion, said he had similar questions about how the outbreak started, how Wanaque administrators responded and told state officials, and the DOH’s oversight of the process. It is not clear that new laws or regulation are needed, he said, but a full review of the situation is imperative.

Republicans say state response fell short

“It could be a matter of compliance or enforcement of existing rules,” Vitale added. “We could be missing something in the (response) process.”

Assemblyman Herb Conaway (D-Burlington) a physician who chairs that chamber’s health panel, also expressed his sympathies to the families and friends of those who died or were infected. “In addition to my condolences, I am committed to helping uncover the source of the adenovirus and determining what legislative and clinical measures can be taken to reduce future occurrences,” he said.

Assemblywoman Gabriela Mosquera (D-Camden), chair of the Women and Children Committee, also pledged to do her part to help identify the cause and prevent future outbreaks, as did Assemblywoman Joann Downey (D-Middlesex), who heads the Human Services Committee.

But a trio of Republican lawmakers who represent the Passaic district that includes Wanaque said that the state’s response, while quick, fell short of what patients’ families deserve. They called for justice for these victims and pledged to hold the Democratic administration accountable so this “never happens again.”

“The children who died were already at a high risk of infection. They needed more care and more oversight; not less,” said the statement from Sen. Gerry Cardinale and Assembly members Holly Schepisi and Robert Auth.